<h1>{PAGE_TITLE}</h1>
			
			<div id="contact_content">
				<div id="contact_form">
					<div id="contact_form_title">Heeft u een vraag? Mail dan gerust.</div>
						{PAGE_CONTENT}
						<form id="contact" method="post" action="">
							<div id="contact_form_holder">
								<div class="new_field">
									<div class="form_name">Naam:</div>
									<div class="form_input"><input type="text" name="name" class="contact_text" id="name" value="" /></div>
								</div>
								
								<div class="new_field">
									<div class="form_name">E-mail:</div>
									<div class="form_input"><input type="text" name="email" class="contact_text" id="email" value="" /></div>
								</div>
								
								<div class="new_field">
									<div class="form_name">Onderwerp:</div>
									<div class="form_input"><input type="text" name="subject" class="contact_text" id="subject" value="" /></div>
								</div>
								
								<div class="new_field">
									<div class="form_name">Bericht:</div>
									<div class="form_input" id="form_textarea"><textarea name="message" id="message"></textarea></div>
								</div>
								
								<!--<div class="new_field">
									<div class="form_name">Captcha:</div>
									<div class="form_input" id="form_textarea">
										<br />
										<input type="text" name="captcha" id="captcha" value="" />
									</div>
								</div>-->
							</div>
							<div id="contact_form_submit">
							 <input type="reset" name="reset" value="Velden Wissen" /> <input type="submit" name="submit" value="Verzenden" id="contact_submit" />
							</div>
						</form>
				</div>
			</div>